My cat’s eyes are swollen and teary

What is conjunctivitis?

Conjunctivitis is the inflammation of the conjunctiva. The conjunctiva is the thin semi-transparent mucous membrane lining the inside of the eyelids, covering the third eyelid. This membrane attaches to the globe of the eye at the level of the sclera (the white part of the eye). The back end of the word conjunctivitis (– itis) refers to inflammation which is a defense mechanism of the body and means swelling, redness, increased heat to the local area because of an increase in blood flow to the affected area, and pain or discomfort. Conjunctivitis is a very common condition affecting our household cats.

What causes conjunctivitis?

This condition is typically caused by infectious organisms such as viruses like Feline Herpes Virus or Feline rhinotracheitis virus or bacteria such as Chlamydophila Felis or Mycoplasma. Other causes can include trauma to the eye which most cats typically sustain through cat fights, immune-mediated conditions where the body overreacts to a stimulus and ends up causing more damage to itself, or sun damage especially in white cats with unpigmented eyelid margins. Infectious causes of conjunctivitis are the most common and are important to treat, but more importantly prevent, as the infection may spread from one cat to another. Infectious conjunctivitis is usually a condition affecting younger cats. Cats that may be at increased risk for infectious conjunctivitis include those that live in multi-cat households, cats taken to the kennels or a cattery, cats exposed to other sick animals at the vet, or free-roaming cats that come into contact with all the neighbourhood’s cats. Another risk factor for this condition is the presence of an underlying immunosuppressive condition such as FeLV (Feline leukemia virus) or FIV (Feline Aids) which predisposes affected cats to these infections due to their reduced ability to fight off infections.

Cancer of the conjunctiva more commonly affect older cats, typically cats with no pigment in their eyelid margins. Their eyelids are effectively sunburnt and the process starts off with inflammation of the eyelids causing conjunctivitis, and eventually progresses to full blown cancer.  If sun exposure can be restricted or contained, this condition can be prevented. 

What are the clinical symptoms of conjunctivitis?

Clinical signs may vary in degree and affect one or both eyes. Your cat may have painful red eyes, some discharge from the eye which may be either watery or pussy in later stages of the disease, and in severe cases the eye may even be closed due to excessive swelling of the conjunctiva. These signs may be recurrent and vary with severity during the course of the disease. With infectious causes such as viruses there are often signs and symptoms of other upper respiratory tract infections such as sneezing, discharge from the nose and a loss  of appetite partly due to a loss of smell.

How is conjunctivitis diagnosed?

Conjunctivitis is diagnosed by the veterinarian carefully examining the eye and all its adjacent structures and looking at all the different parts of the eye. What vets often look for is the presence of red inflamed conjunctiva, discharge from the eyes, signs of trauma or potential causes of the inflammation. If a cat with conjunctivitis is presented to the vet,  the vet may do certain tests to check other parts of the eye such as the cornea, tear duct function and even eyeball pressure. This is important to rule other eye conditions which also have conjunctivitis as a symptom, but requires a completely different approach to treatment. These tests include a fluorescein dye test, where a luminescent green dye is applied to check for any defects or ulcerations of the cornea (the glassy clear layer on the front of the eyeball through which the animal looks). Another test is the Schirmer tear test that checks the tear production and determines if your pet suffers from dry eye. Lastly, the vet may want to test the eye’s pressure to determine if glaucoma may be present. Glaucoma is a condition of increased pressure within the eyeball, causing gradual loss of sight. On some occasions, if treatment is not working, more in-depth procedures such as blood tests, biopsies and conjunctival samples for bacterial growth may be necessary to determine the underlying cause of the conjunctivitis.

How is conjunctivitis treated?

The treatment goals for any case of conjunctivitis in cats include treating the underlying cause, eliminating infection (if present/possible), and reducing pain and discomfort. If there is an underlying cause that has been identified, this will be treated. Generally the treatment entails eye drops that need to be given at home according to the vet’s instructions. On this note something many of us are guilty of is trying to self medicate our cats with human over the counter eye drops. This is not a good idea as some human medications are  contra-indicated in cats and by using the wrong medication we can actually do harm and make the condition worse. Always seek the advice of the vet before applying any medication. This also applies to eye drops prescribed by the vet previously or to another animal in the house hold. If the eye medication contains cortisone and there is ulceration on the cornea, it will only worsen the ulcer and your animal may lose its eye.

What is the prognosis if my cat has conjunctivitis?

The prognosis of conjunctivitis is generally good but depending on the cause of the conjunctivitis, certain complications may arise. Infection with herpes virus may lead to a corneal sequestrum, symblepharon (partial or complete adhesion of the eyelid conjunctiva to the eyeball conjunctiva), or dry eye. These conditions are permanent and the cat will never recover fully if complications like these arise.  Conjunctivitis may be recurrent or chronic in some cases of infections. Because cats with herpes virus are often chronic carriers it is important to reduce stress in the environment as that is often the trigger for recurrent infections. Cats with underlying Feline Leukemia Virus (FeLV) or Feline Aids Virus (FIV) cannot be cured and because of their compromised immune systems, will always be prone to complications. Because of the recurrent nature of conjunctivitis in certain cats please do not lose faith in the vet or his or her ability to treat your cat. Work with the vet to understand the specifics of your cat’s condition and if the condition cannot be cured with a once off treatment, work out a strategy with the vet to manage the condition as effectively as possible. As with all medical conditions in pets, the sooner you attend to the problem once you notice any symptoms of conjunctivitis in your cat, the higher the likelihood of success with treatment. Don’t leave it till the cat can hardly see from its eyes and only then try and do something about it.

Is there a way to prevent conjunctivitis in my cat?

The answer is an unequivocal YES! By far the most effective way to prevent your cat from getting conjunctivitis is to have it vaccinated at the correct intervals and with the correct vaccines to prevent the upper respiratory tract diseases collectively known as “Snuffles”. Is it fool proof and will vaccination definitely prevent your cat from contracting these diseases? The answer is no. Sometimes viruses mutate or different strains infect your animal to what was in the vaccine. Does this mean that vaccinating is “fighting a losing battle”? Not at all. Having your cat vaccinated is certainly the best way to prevent disease, but does not guarantee that they won’t get infected. Making plans with cats who roam and land up in fights is a tough task, but can be done when there is a will to do so. Keeping cats with unpigmented eyelids indoors and out of the sun, is also a tough task because cats are by nature so inquisitive. Yet, if is means a better quality of life, cancer free, it is a small price to pay. Discuss your cat’s particular circumstances with the vet and find a solution with professional help.

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There is something wrong with my dog’s eyes

What is “dry eye?”

Keratocunjunctivitis Sicca (KCS) or dry eye as it is commonly known, is a condition found in humans and animals where the eyes do not produce enough tears or moisture for the eyeballs to stay moist and shiny.

Which animals are prone to dry eye?

The condition is common in dogs and rare in cats. Cats who do suffer from the condition tend to show fewer symptoms of eye problems than dogs.  Certain dog breeds are predisposed which include Cocker Spaniels, Bulldogs, West Highland White Terriers, Lhasa Apsos and Shih Tzus.

What are the symptoms of dry eye?

The symptoms associated with the condition can vary and are not necessarily very specific. This is why the owner of a pet with dry eye will realise there is something wrong with the dog’s eyes, but they cannot exactly describe what it is. The typical symptoms which one may notice vary and may include a combination of redness and swelling up of the inside of the eyelids (called chemosis), redness of the sclera (the white part of the eye next to the front “see through” (cornea) part of the eye), a discharge in the corner of the eyes, eyelids which are half open or sometimes closed tightly (blepharospasm), the third eyelids starting to move over the eyeball from the inside corner of the eye.  Humans with this condition will tell you that it feels like there is sand in their eyes. One can imagine that if there is not sufficient moisture or tears to lubricate the eyeballs that the movement of the eyelids over the eyeball becomes strained every time the animal blinks.  In bad cases which have been going for a while, the dryness on the eyeball can cause ulcers to start forming on the cornea with tiny blood vessels starting to appear on the shiny “see through” front part of the eyeball, the cornea. In severe cases, dry eye can lead to loss of vision and partial blindness.

Causes of and risk factors for dry eye

There are a wide range of reasons, conditions and external causes which can lead to dry eye.

Immunologic – Diseases, where the immunity of the animal is compromised or excessively challenged in one way or another, can lead to dry eye. One example is Atopic Dermatitis. This is an allergic skin condition often brought on by the inhalation of allergens like pollens (similar to hay fever in humans), which causes overall itching and scratching with areas of the skin being irritated and red and inflamed.

Congenital – A condition an animal is born with, with certain breeds like Pugs and Yorkshire Terriers more commonly affected.

Neurogenic – occasionally seen after trauma to the face like bite wounds or a car accident where the nerves supplying the tear gland or lacrimal gland are damaged.

Drug or procedure induced – Atropine which is a drug sometimes used to expand the iris so a proper eye exam of the back of the eye (the retina) can be performed will sometimes lead to a transient dry eye. In time this should clear up with no medication required. The same thing can happen when an animal is given a general anaesthetic (GA) and the vet forgets to put an ointment in the eye to cover the cornea, whilst they are doing a medical or surgical procedure. Most people do not realise that animals who are under general anaesthesia sleep with their eyes open. If dry eye happens because of a GA, it will usually clear up by itself a few days later.

Drug toxicity – One group of antibiotics called potentiated sulphonamides have been known to

cause transient or permanent dry eye.

Iatrogenic – Iatrogenic refers to an illness which is brought on by human intervention, typically a medical examination or treatment. The most common cause in dogs will be the removal of the third eyelid or membrana nictitans. There is a condition where this third eyelid starts moving over the eye and only in very exceptional circumstances should this third eyelid ever be removed.

Radiotherapy – Cancer of the eyelids is common in animals with white skin or low pigment in their skin. The treatment of this cancer may require radiotherapy where the beam needs to be aimed at the eyelids with the result that the eye itself is being radiated as well and this can lead to dry eye.

Chronic conjunctivitis – An inflammation with redness and swelling of the eyelids. This condition is more common in cats who suffer from chronic herpes or chlamydia infection.        

Can dry eye be confused with other conditions of the eye or the eyelids?

Yes indeed. Dry eye can often be confused with bacterial conjunctivitis. The reason for this is that dry eye will often lead to a situation where there is a secondary overgrowth of bacteria because of the compromised situation of the eye and eyelids. The secret to differentiate lies in the diagnosis which is discussed below.

How is dry eye diagnosed?

Dry eye is diagnosed with the Schirmer tear test. The Schirmer tear test is a simple procedure where a small piece of special absorbable paper is bent over on the one side and hooked on to the lower eyelid of the animal. The rate at which the paper gets wet and the moisture moves down on the piece of paper determines whether enough tears are formed to keep the eye wet. Usually, the paper needs to get wet at the rate of 14 mm per minute. If this does not happen and the paper only gets wet too for instance 5 mm within a minute, it confirms a diagnosis of dry eye.

Other diagnostic tests which the vet may want to perform are fluorescein staining where a bright orange fluid is dropped onto the eyeball. If there is an ulcer on the cornea (which often happens with dry eye) the colour will turn a bright green. If an ultraviolet light is shown onto it, it will turn even brighter and “fluoresce”. The vet may want to take a swab of the eye to do a culture and antibiogram in cases where treatment seems to be unsuccessful. The vet may also want to do a cytobrush test where a tiny “roller brush” is rolled onto the inside of the eyelids, smeared onto a microscope slide, and examined under a microscope. The diagnostic tests done will depend on the particular circumstances of each individual animal suspected to be suffering from dry eye.

How is dry eye treated?

Animals with a confirmed diagnosis of dry eye are usually treated as outpatients. The eyes have to be cleaned before the medication is administered. Owners are usually instructed to keep the eyes and the area around the eyes as clean as possible on an ongoing basis. This is usually done with wiping the eyelids with cotton wool or cloth moistened with lukewarm water or a saline solution. If the animal seems to be developing more pain as the treatment goes on, it is important to get such an animal back to the vet as soon as possible because animals with dry eye are predisposed to severe corneal ulceration if not attended to. In previous decades, before more modern and effective medication was available to treat dry eye a surgical procedure was done were the parotid duct, a small duct which transports saliva from the salivary glands to the back of the mouth, was surgically redirected to the corner of the eye. For lack of anything else this procedure did help to some degree but the saliva tended to be irritating to the cornea and some animals were always uncomfortable after surgery. Fortunately, there are great and effective drugs available to treat this condition today and the two most commonly used medications which stimulate the eye to produce tears are Cyclosporin and Tacrolimus. The vet will assist you in choosing the right option for your pet.

Prognosis for dry eye

Depending on the cause of dry eye, the outcome of treatment is usually very positive these days with the drugs available to help stimulate tear production for the eye. If there are no other conditions like ulceration of the eye, complicating the treatment, animals with dry eye can live good quality lives until they die but will most likely require life long treatment and regular veterinary checkups.

If you are not sure if your dog who seems to have an eye problem has dry eye, bring him or her to the vet for a checkup and have the correct diagnosis made and correct treatment recommended.

© 2019 Vetwebsites – The Code Company Trading (Pty.) Ltd.

My dog has what looks like a red cherry stuck in the corner of its eye

Introduction to cherry eye

Prolapsed gland of the third eyelid

A cherry eye is a non-life-threatening condition that occurs in dogs, and less often in some cat breeds.  It is an extremely descriptive term, as one can see an oval, bright red swelling in the inside corner of an affected dog’s or cat’s eye, resembling a cherry. As a pet owner one can easily become quite alarmed by seeing this, but fortunately, it only causes slight irritation to the dog initially and you will have time to attend to it and take your animal to the vet before the condition gets out of hand. It is never a good idea to just leave it be. The condition tends to occur more commonly in younger dogs and cats, usually between the ages of 2 and 6 years.

How does it happen that an animal develops a cherry eye?

A cherry eye is in actual fact a protrusion (or bulging out) of the gland of what is colloquially called the third eyelid. Dogs and cats have three eyelids, the top and bottom lids that close up and down over the eyeball as in humans, and then a third eyelid, otherwise called the nictitating membrane underneath the upper and lower eyelids. If you press on the eyeball through the upper eyelid, you will notice the third eyelid moving across the ball of the eye from the inside corner of the eye towards the outside corner of the eye.  This eyelid contains a gland that produces up to 30% of the tear production of the eye. The third eyelid provides extra protection to the animal’s eye and keeps the eye moist. The gland in the nictitating membrane is anchored to the corner of the eye by a connective tissue band. For reasons unknown, this connective tissue starts to weaken and the gland slips out of its pocket. If this happens, the gland is exposed to sun, wind, dust, and trauma from the outside. The gland becomes red and swollen, and eventually painful, due to inflammation. One or both eyes may be affected at the same time. The most common breeds affected by this condition are Beagles, Bulldogs, Spaniels, Shih Tzus, Pekingese, and other brachiocephalic (flat-faced) breeds. The condition is rare in cats but Burmese and Persians seem to have a higher incidence of cherry eye.

Other clinical signs associated with cherry eye.

You will quickly notice the red swelling in the corner of your animal’s eye. Other signs that you might notice are a mucoid discharge from the eye and/or redness in the tissue surrounding the eye, called conjunctivitis. Your pet might also show you he/she is experiencing discomfort by pawing at the eye or rubbing his/her face against objects. This can cause even more trauma to the exposed gland.

Course of action with cherry eye

Due to the fact that some dogs don’t seem phased by the popped out gland, some owners might opt to leave it like that. Not treating the gland may however cause more serious problems to the affected eye in years to come. As more damage is inflicted onto the popped out gland, the amount and quality of tear film that protects the eye will decrease causing chronic inflammation and irritation to the eye. The best would be to get treatment of the infected cornea eye as soon as possible. The vet will examine the eye closely and will usually recommend replacing the gland surgically. The vet may stain the cornea with a fluorescein stain to check for ulcers on the eye itself that might have occurred during protrusion of the gland. A few decades ago, it was common practice to remove the gland surgically when it protruded. This is not the practice any longer because by removing a gland that produces tears, the affected eye can dry out causing a condition called keratoconjunctivitis sicca, or more commonly referred to as ‘dry eye’. It is therefore no longer recommended to remove the gland surgically, unless the gland is so traumatised that it will lose its function in any case. Replacing the gland into its original position is usually done under general anaesthesia by anchoring the gland in its pocket with suture material. For an experienced veterinary surgeon it is a relatively easy surgical procedure to perform. The most common complication is a re-occurrence of the cherry eye and trauma to the cornea by suture. If the condition re-occurs it certainly does not mean that the vet did a hopeless job. Between 5 and 20% of dogs have a recurrence of the condition after the surgery. The reason is that the gland can protrude and prolapse to the other side where the sutures were not placed. If it happens the procedure just has to be repeated. There is no way of predicting whether your pet will be one of the unlucky ones where the condition recurs after the initial surgery.

Conclusion

It is not clear why the connective tissue of the third eyelid housing the tear gland weakens causing a cherry eye other than that there seems to be hereditary component.  It is therefore not recommended to breed with affected dogs. Taking your dog to be examined by the vet as soon as you see the signs of cherry eye, can save you a whole lot of problems with your pet’s eyes later in his/her life, and even save his or her eyesight.

© 2019 Vetwebsites – The Code Company Trading (Pty.) Ltd.

My dog’s nose seems to be all clogged up and hard and he is not well at all

Canine distemper

Following recent outbreaks of Distemper (Hondesiekte in Afrikaans) in Kwa Zulu Natal and Gauteng, it is important to have an understanding of this disease which is fatal in half of all cases of dogs that contract the disease.

What causes Distemper?

Distemper is a virus disease caused by the Canine Distemper Virus or CDV. This virus is a morbillivirus in the Paramyxoviridae family which is a virus group that affects humans, vertebrates and birds. This specific virus is not transmissible to humans but specifically targets dogs hence the name “Canine” Distemper Virus. The virus is closely related to measles virus in humans, and also to rinderpest virus in cattle, which at the beginning of the previous century almost killed the entire cattle population of Southern Africa. It’s a nasty virus.

What are the symptoms of Distemper?

The virus attacks mainly the respiratory system (from the nose right into the lungs), the gastro-intestinal system (from the mouth, through the stomach into the small and large intestines) and the central nervous system (mainly the brain). This means that the symptoms associated with the disease will be related to problems with these three main systems. In acute to subacute infections the dog will usually develop a fever within a day or two from being infected. The dog will go off its food and become weak and lethargic

Respiratory system symptoms may include a clogged up nose typically with mucous or slime that becomes hard, and hardening of the nose itself. This is a very telling symptom of Distemper but is by no means the only, or most typical, presentation of the disease. A dog with distemper may have a perfectly normal nose and still have the disease. Many times there will also be a discharge in the corners of the eyes. Other respiratory symptoms include coughing, sneezing and difficult breathing if the virus attacks the lungs.

If the gastrointestinal systems is affected you may see vomiting and/or diarrhoea.

If the central nervous system is involved you may have muscle tremors, a dog which seems disorientated and walks around as if they are drunk (ataxia), hind limbs which are dragged or seem lazy (paresis), a dog which cannot get up or falls down when they do get up (paralysis), and even seizures. Other symptoms which are not immediately visible and which only the vet may be able to pick up are lesions on the retina at the back of the eye, or an inflammation in the front of the eye called anterior uveitis. Hardening of the footpads  (hyperkeratosis) was previously quite common because of the strains of virus involved, but seem to be less common these days.

How is Distemper diagnosed?

There are several blood tests which can be done by the vet, but it is a difficult disease to diagnose because unlike a disease like biliary or tick fever in dogs where you can see the parasite in the blood with a bloodsmear, in Distemper, as with all other virus diseases, you cannot see the virus as it is simply too small. The trouble with the blood tests are that they are often not conclusive. The reason for this is that some of the tests, test if the dog is building up antibodies (“soldier”) against the virus. However a dog that may previously have been vaccinated may show antibodies and not have the disease. Sometimes the dog may die acutely before the body was able to produce neutralising antibodies, so in that case the test may be negative, yet the dog still had the disease.

Another type of blood test where the white and red blood cells are counted and where the white cells are less than usual, called lymphopenia,  may give an indication that the dog has a virus disease but it will not tell which virus the dog has.

If the dog has central nervous system symptoms, the fluid around the brain and spine called Cerebro Spinal Fluid (CSF) may contain antibodies but once again it may not be 100% diagnostic. There are other tests which can be run on the CSF (cell or protein content) which may be indicative, but does not conclusively confirm that the dog has Distemper.

There are a number of other diseases which can present with similar symptoms which the vet will have to rule out. On the respiratory side there is Kennel Cough or other upper respiratory tract infections. On the intestinal side there is Parvovirus and Coronavirus, parasitism like worms or Giardia, bacterial infections, toxin ingestion or inflammatory bowel disease. On the neurological side there is granulomatous meningoencephalitis, protozoal encephalitis (toxoplasmosis, neosporosis, babesia), cryptococcus or other infections (meningitis, Ehrlichiosis), pug dog encephalitis and lead or other poisoning.

Clearly Distemper is not a simple disease to diagnose and the vet will often have to rely on the age of the dog, its history, the results of the clinical tests and the appearance of the clinical symptoms, to make a diagnosis of Distemper.

How is Distemper transferred?

The virus is typically inhaled through the air from other sick dogs and also from physical contact with infected animals. The virus can survive for a period of time in the environment and if a dog which carries the virus sniffed around or spent time in a certain environment, it will leave tiny, tiny droplets (aerosol) which contain the virus in that area, which can then infect other dogs. A dog which is infected will inhale or ingest the virus and the virus will quickly spread through the mucous membranes to the local lymphnodes (these are like the remote “army bases” of the body which has to protect the body against invasions) where it will multiply and within one week the whole body will be infected.

How is Distemper treated?

Vets have over the years tried antiviral drugs of which there are very few anyway,  and none have been effective. As with almost all virus diseases one has to support the body in its own fight against the virus because it is only once the body has been successful to produce antibodies (the “soldier cells” which kill the “terrorist” or virus), that the dog will be able to overcome the disease. Often, when the body is attacked by viruses and the immune system is fighting hard to overcome the infection, bacteria will cause a secondary infection and make the whole situation worse. Therefore antibiotics are often administered even though it will do nothing against the virus, but at least it will help the body fight off opportunistic bacterial infections and help the body to overcome the disease. Other treatment depends largely on which systems are affected and to what extent. The vet will typically give symptomatic treatment, for example if the dog has seizures, the vet may administer a drug to help contain the seizures and make them less violent. Certain drugs should not be given and it is important to consult with the vet in case you think your dog may suffer from Distemper.

Can Distemper spread to humans or cats?

In the past it was suspected that the Canine Distemper Virus can cause Multiple Sclerosis in humans. However this has been proven NOT to be the case and as far as we know the disease cannot spread from dogs to humans. Similarly, as far as we know, this disease cannot be transferred to domestic cats.

What is the prognosis should my dog contract Distemper?

Unfortunately the prognosis is not good and the mortality rate is 50%. It will be very difficult for the vet to tell whether your dog will fall in the 50% that will survive or the 50% that will not make it. The vet will have to assess the extent and severity of the clinical symptoms and the progression of the disease and based on that, will advise you whether treatment has any chance of success or not. An important thing to remember is that even though the disease may not appear to be very far advanced when you first present your dog to the vet, and there seems to be early good response to treatment, like the clogging of the nose and the discharge in the eyes clearing up, the dog may still develop fatal central nervous system signs later on. It is important to understand that the vet has no control over which way the disease may go and will do his or her best with your animal’s best interest at heart, when recommending treatment or not.

Can Distemper be prevented?

A resounding yes! Vaccination has been hugely effective in almost eradicating this disease and all dogs should be vaccinated, preferably yearly at the same time as their annual health exam. Your vet will give you more specific advice related to the area you live in and the risk factors involved and should the vet think that annual vaccination is not necessary, the vet will advise you accordingly.

Puppies and old dogs are more commonly affected and all puppies should go through an initial vaccination program from 6 weeks onwards to provide protection. Puppies born from mothers who were vaccinated and had antibodies will get this protection from the initial milk or colostrum from the mother in the first few days after birth. The protection provided through the mother’s milk will start waning after six weeks and this is why vets normally start vaccinating at this time, and repeating the vaccination three or four times with booster vaccinations with monthly intervals and then yearly thereafter.

What do I do if I suspect my dog to have Distemper?

Get them to the vet as soon as you can. Home remedies or treatment is unlikely to give your dog a fighting chance. Proper supportive and secondary infection treatment remains the mainstay of treatment.

Most importantly, have your dog vaccinated. Prevention is always better than cure!

© 2019 The Code Company Vetwebsites

My pet injured its eye!

Just like in people, the eye of a dog or cat is a delicate structure that can be affected by a huge number of different conditions. This article will cover trauma to the eyelids, third eyelid and cornea.

Anatomy of dogs and cats eyes

The eye of the dog and cat is very similar in structure to the human eye but there are one or two differences. Both a cat and dog’s eye is globoid (round) in shape. The part of the eye exposed to the outside is protected by the eyelids and eyelashes, just as in people. The cornea is the see-through part of the eye. It is a thin layer, allowing light to pass through the pupil and lens to the back of the eye.  The white of the eye is known as the sclera. The conjunctiva is the pink part of the eye that can be seen between the eyelids and the eyeball. Dogs and cats both have an extra membrane, known as the third eyelid or nictitating membrane.  This membrane can be seen in the inner angle of the eye and sometimes it can cover most of the eye, particularly following trauma. 

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Trauma to the eyelids

The eyelids are the first structures protecting the delicate eyeball from the outside and potentially trauma. Due to being more active, getting into fights and exploring, cats and dogs are more prone to traumatizing their eyelids. Lacerations or cuts to the eyelids are a fairly common injury seen in most veterinary practices.  If there is any trauma to the eye, it is important to take your pet to the vet. Some injuries may be superficial and cleaning the wound with disinfectant may be all that is required. In other cases, the eyelid may need to be stitched back together. The sooner the eyelid is stitched, the better the chances of it staying together. It is very important that the eyelid margin (that is the part that the eyelashes attach to) remains smooth. If there is a kink in the eyelid margin, this can lead to further trauma to the eye and it can damage to the sensitive cornea.  Once the eyelid has been stitched, your pet may require eye drops for a few days to assist with the healing and prevent any infection.

Trauma to the third eyelid

Sometimes the third eyelid can be lacerated. This is commonly seen in cats that have been involved in a fight and have been scratched in the eye.  If the third eyelid is badly traumatized, it may need to be sutured.

Trauma to the cornea

Corneal ulcers

The most common injury seen to the cornea is corneal ulceration. This is where the first outer layer of the cornea (the epithelium) is damaged, exposing the more sensitive inner stroma of the cornea. This can be very painful. A scratch to the eye or a splash of shampoo or other caustic substances can cause an ulcer.  There are some viruses, such as herpes virus in cats that can also cause ulcers in the cornea. Often we do not know what has caused the ulcer. If you notice your dog or cat squinting, or the eye is closed and seems painful, then it is important to take them to the vet immediately. Often the conjunctiva will also be inflamed. This is known as conjunctivitis. The eye may also have some discharge.

The vet will examine the eye with an ophthalmoscope. This will allow the inside of the eye to be seen and ensure that there is nothing else going on. The vet will then perform a fluorescein test. This is where an orange stain is placed on the cornea. The eye is then looked at with a UV light (blue coloured light). If there is any defect in the cornea, this will show up as bright green. The corneal epithelium does not take up any stain but if the stroma is exposed it will take up the stain. 

Corneal ulcers can vary in size and severity. It is important to start treatment as soon as possible as the quicker it is treated, the more likely it is to heal. If the injury is superficial and small topical treatment with eye drops remains the most effective treatment. It is important that eye drops containing corticosteroids are not used as this delays the healing of the cornea and can, in fact, make the ulcer worse. Other drops and medications may be needed for pain control or to maintain the eye’s lubrication. The eye will need to be assessed daily to ensure that it is healing. In some cases, further treatment will be needed. In severe cases, the ulcer may need to be covered with either the third eyelid or some conjunctiva. This procedure will need to be done under general anaesthetic. The flap is placed over the cornea and sutured in place to give the cornea time to heal. The vet may even give you a referral to a specialist veterinary ophthalmologist which is a vet who would have done between four and six years of extra study over and above their veterinary degree, to become an eye specialist.

There is no set time to how long the cornea will take to heal but daily checkups are required initially to ensure that the condition is not deteriorating. In very severe or long-standing cases, the eye may even need to be removed. 

Foreign bodies within the eye

Penetration of the cornea by foreign bodies such as thorns, glass and sand can be seen in dogs and cats. This is normally very painful and can quickly lead to infection within the eye. If the foreign body is just penetrating the surface of the cornea, it may be removed with the aid of local anaesthetic. In severe cases, where the foreign body has penetrated deeper into the cornea and eye, it will need to be surgically removed. Fine instruments are often required in order not to damage the eye further and this procedure may need to be performed by a specialist ophthalmologist. If your pet is showing any signs of pain or discharge to their eye, it is important to seek immediate veterinary attention.

What is the prognosis with eyelid and corneal trauma?

The prognosis of injuries to the eyelids and cornea will depend on the severity of the trauma. If treated quickly, then permanent damage to the eye is minimized but this does depend on how extensive the injury is. The cornea scars white and so if the ulcer is very deep or long-standing this can affect the eyesight, particularly if the scar forms over the part of the cornea that is in front of the pupil. It is important to remember that the quicker it is treated, the more successful the treatment is likely to be. If you notice any pain, discharge or redness to your pet’s eye, it is important to take them to vet for an assessment. You may ask how do you determine that your pet experiences pain in their eyes? Apart from you visibly seeing damage to the eye or noticing an eye which is excessively teary, you will most likely notice your pet scratching at the injures eye with their front paw or alternative scratching the eye or face on furniture or the carpet, in an effort to relieve the discomfort and pain. If you are in doubt, err on the conservative side and get your pet to the vet as soon as you can. The loss of eyesight through the loss of an eye is simply not worth risking seeing whether the animal will get better by themselves.

© 2018 Vetwebsites and The Code Company 

The vet could not cure my pet!

First things first, there are always 3 parties to any veterinary consultation: The vet, the pet and the one often overlooked, the owner. For any veterinary treatment to be successful at least two of the three parties, namely the vet and the owner, are pivotal to the success of any intervention. As an owner, you are the eyes and ears of the vet in the home environment and most importantly no one knows your pet the way you do. The truth is we the vet cannot do their job without you. I am sure many have heard the saying that vets have it harder because their patients don’t talk, they can’t tell the vet what is wrong, or where it hurts. It is for this reason that a vet will require every bit of additional information they can get from you, the owner. Animals are as biologically complicated as people, in fact, most medical ailments affecting people can affect animals.

When any consultation starts the first thing a vet starts doing is asking you questions about your pet, this is what we call history taking. It is the first step to working out the puzzle and coming to a diagnosis in order to treat.  These question can include activity levels, appetite, urination, defecation, history of limping or pain, what is in the environment at home, has anything changed etc. Vets are many things, but they are certainly not mind readers and these are pertinent questions which help the vet identify the problem. So as an owner it is your responsibility to be aware of what is going on in your pet’s life. You are the closest thing they have to being able to speak. Always remember that you know your pet better than anyone else and you will be able to notice changes much sooner. So don’t hesitate to bring your pet to the vet if you suspect something to be wrong with your pet. Sooner is always better.

Now that the consultation has started your vet will be doing the clinical examination and this involves some uncomfortable things like having their temperature taken via the rectum. The better part of the physical clinical examination is an invasion of your pet’s personal space in an environment where they are already scared, nervous and anxious. If you know your dog or cat is nervous and may potentially bite, it is always a good idea to inform the vet in advance. Although most vets have “spiderman reflexes” they don’t particularly like getting bitten when they may just not be fast enough to escape a hurting or nervous animal’s defence mechanism. Most dogs will never bite their owners, so you are essentially the safety net for your vet. You need to hold your pet and if they become aggressive, don’t let go. If you are at all concerned they may harm you or feel you will be unable to restrain your pet adequately, let the vet know. Vets have contingency plans such as muzzles and most of the time, wonderful, experienced handlers that can assist. When everyone feels safe, then everyone is relaxed and tension subsides and often the animals will calm down in response to this.

Luckily most of the diagnostic procedures and some in-hospital treatments (surgeries, drip, injections etc.) don’t involve you as an owner to a large degree. However, when your pet goes home on medication and home treatments, it’s all about you. Unfortunately, treatments and medications don’t work if they aren’t given. If the vet prescribes a course of medication, dose as instructed and always finish the course, especially if it is antibiotics. If wounds need to be cleaned, or ear/eye drops applied, they must be done as instructed. Always remember the vet knows better than anyone else how difficult animals patients can be when it comes time for giving medications. A useful tip when dosing medication for dogs: Hide them in something tasty like a Vienna sausage, cheese, peanut butter (check no xylitol in sugar-free alternatives), ham or anything tempting enough for your dog. A good idea is to offer a few pieces of your treat of choice without any medication in, then once your unsuspecting dog is sure there is nothing unsavoury in the treat, sneak the tablet laden one in, with the next clean one following in quick succession, and they often gobble it up without even tasting it. If you have one of those stubborn, clever dogs who delicately eats the treat and leaves the tablet untouched, you will have to learn to dose your pet properly. This involves placing the table in the back of the throat behind the tongue.  Ask the vet for a demonstration.  Cats, on the other hand, are a whole different kettle of fish. Most cats will not willingly eat medication whether or not it’s disguised in something tasty. They will generally require direct oral dosing of medication. The technique for pilling a cat can be demonstrated by the vet, and a few practice rounds in the consulting room is always a good idea. Once you have the knack pilling them comes the trouble of catching them to actually give the medication. After day three they will normally have learnt to avoid you when it comes to tablet time. Something that often works to reduce the negative association of dosing medication is giving them a treat afterwards, something tasty and very tempting.

Monitoring the response to treatment and recovery from treatment is essential for the owner. If your pet is not getting better or not responding as expected, they must be brought back into the vet. Complicated cases may require several diagnostic steps and treatment options to get it right. If the vet has scheduled a follow up to monitor the response to treatment, then your pet should be brought back for their check-ups. This helps the vet keep on top of treatment and progress. Vets, in general, are very busy, they see consultations, monitor and treat in-hospital patients, perform surgeries, research cases and manage practices. Although vets try to stay on top of everything they are human and sometimes things can slip their minds. It is important for you as an owner to take responsibility and contact the vet if you have any concerns, queries, you are looking for updates, or are looking for results for anything if the vet hasn’t come back to you timeously.

Vets rely heavily on you, the owner, for treating their animals successfully. Without the owner’s care, commitment and involvement in the treatment and care of their pets after they have been to the vet, the vet has almost no chance of achieving the successful outcome they desire for your pet’s treatment.

© 2018 Vetwebsites, The Code Company

My dog is really getting old

Taking your elderly dog to the vet for an annual check-up can sometimes feel like a waste of time and a big inconvenience to the pet involved. The stress involved and the difficulty of transporting a big elderly dog, which is not so mobile anymore, may make you wonder if it is really necessary. The answer is a very big YES!

At what age exactly are dogs considered geriatric? You may find different views on the internet and as with humans, it does depend to a large degree on the individual animal. Some humans are sprightly and active at age 75 and others are tired and sickly at age 60. The same applies to dogs but there is a general consensus that small breed dogs generally have a longer life span than medium and large breed dogs. Giant Breeds are considered geriatric at the early age of 6 to 7 years, whereas breeds are only regarded as geriatric when approaching ten to twelve years of age.  The aim of an annual check-up for an adult dog is not just to update the vaccinations, but to give the veterinarian an opportunity to evaluate the dog’s general health and pick up any problems that might have gone unnoticed by the owner. The broad generalisation is that for each one year a human ages, a dog will age the equivalent of 7 years. If you look at it in this light, it will make sense that in older dogs, regular check-ups, as in humans, are vital. The vet will also ask the owner a series of questions to establish how the animal is doing at home. Things to start looking out for when an animal gets older is a loss of appetite, losing weight, struggling to get up and move around, as usual, drinking and urinating more than usual, and general signs like vomiting and diarrhoea.

As the animal’s body ages, it goes through normal changes and often it is an accumulation of these changes that result in health problems. The most common problem that old dogs deal with is arthritis, and as older animals become less active they tend to become overweight. Extra weight places extra stress on already painful and inflamed joints. These patients might need to be X-rayed to rule out any other causes of limping and stiffness. Once a diagnosis of arthritis is made, the vet may advise a change in exercise regimen, a change in bedding, potentially a change of diet or adding joint supplementation products on to, or into the animals' food, and often anti-inflammatory medication depending on the severity. The most important method of pain relief remains weight loss.

The organ function of old dogs often decreases as well. A common problem is decreased kidney function turning into chronic renal failure. As the kidney function decreases, it loses the ability to clear the animal’s blood of toxins. Some medications need to be excreted through the kidneys, and if the kidney function is already compromised, it can cause serious side effects. A good example of this is the anti-inflammatory medication mentioned for pain control in arthritic dogs. This group of drugs is excreted by the kidneys and will cause side effects if the kidneys are not functioning well. For this reason, vets will often test the liver and kidney function of old animals before placing them on chronic medication. It is also important to re-test every six months. Animals that suffer from kidney problems will show signs like weight loss and decreased appetite, as well as drinking and urinating more than previously. It is important to take your dog to see a vet as soon as these signs are noted.  These days there are blood tests which can pick up kidney disease much sooner than the blood tests that were available only a few years ago. Yet, sadly, even though these tests are a lot more sensitive, they only pick up kidney disease once 40 % of kidneys are damaged vs the old blood tests which picked it up after 75% of the kidneys were damaged. Veterinary research will keep on evolving to find means of detecting organ failure sooner, but a test with normal results does not necessarily mean that there is not kidney failure. The other important aspect with regards to kidney failure is that the kidneys do not have the ability to regenerate or repair themselves. So, once the cells are damaged, that is it for the kidney. The only way to support the kidneys once damage has taken place is to try and prevent further damage and lighten the load of the kidneys. This can be done by changing the diet and there are specific veterinary therapeutic and prescription diets available for this which the vet can advise you on. Heart failure, as well as liver failure, can also occur showing a various range of clinical symptoms. With heart failure, your pet might be exercise intolerant, start with a cough (especially at night), and breathe faster in general.

Another common problem in geriatric animals is cancer or neoplasia. As the immune system defence mechanism decrease, the ability to recognise cancer cells decreases, and together with oxidative damage in old animals, cancer can occur more commonly. Organ enlargement and organ failure are often an indication of cancer and the vet may recommend an abdominal ultrasound as well as x-rays to pick up cancer. Even the slightest signs in an old animal can indicate a bigger problem. Owners will often complain that the pet has become fussy, and eats less. But this can be the first signs to indicate that a bigger problem exists. It is important to remember that it’s not normal when an animal that has always eaten well, become fussy out of the blue. In most cases old age, as in humans go hand in hand with less active and a lower appetite, but a major reduction in appetite is usually a sign of disease.

So how do you take care of geriatric animals?

  1. Feed a good quality diet: Old dogs cannot digest food as easily as young animals and they need all the nutrients and antioxidants they can get. There are various maintenance, therapeutic, prescription diets specifically formulated for older animals as well as animals with diseases like kidney failure, heart problems, and arthritis. These good quality foods help the animal cope better with their life stage or specific health problem. If there are no particular health problems, a good quality senior diet is preferred. Please speak to the vet to advise you and the best diet to feed your dog.   
  2. Keep their weight stable: With decreased metabolism and decreased mobility, older dogs tend to pick up weight quickly if they don’t have a chronic medical condition. Research has shown time and time again that obese animals have a decreased lifespan. Problems like diabetes and heart conditions are very common in obese animals.
  3. Encourage activity and moderate exercise: It is important to keep them active, but do not overdo this. Regular short walks are more than adequate and only do it if the animal is not in pain.  Swimming in most cases is a really good form of exercise for dogs but not all dogs love water so go with the flow in terms of your dog’s preference.
  4. Good dental care: Dental hygiene is essential in animals of any age. If the teeth are rotten and the gums are inflamed, they may suffer from pain when they eat. The plaque build-up supplies the body with a continuous source of bacteria to the bloodstream. These bacteria can lodge on the heart valves or in the kidney tubules leading to chronic heart and renal failure.
  5. Provide adequate bedding and shelter: Older animals are stiff and sore and will sleep much better with a softer surface to lie on. They also lose the ability to regulate their body temperature adequately and may need extra shelter against heat, cold and other weather conditions.
  6. The most important thing to remember with geriatric animals is to bring them to the vet for annual check-ups. If the vet can help to pick up a disease in the early stages, they might not be able to cure it, but they can definitely make your pet more comfortable and even add a couple of years to your pet’s life by recommending the right geriatric care for your specific dog.

 Old age is not a disease! So if your animal is not eating too well and slowing down, do not just blame old age. Rather seek veterinary advice, you may just save your old dog’s life for a couple more years.

© 2018 Vetwebsites – The Code Company Trading (Pty) Ltd.

My cat is really getting old

Due to improvements in nutrition, veterinary and home care, cats are living a lot longer than they did twenty to thirty years ago. In the past when a cat reached the age of 13 years old, we believed them to be really old. This is definitely no longer the case. We see several cats that are now reaching ages in excess of twenty years. Cats also tend to age a lot more gracefully than dogs and so it is not always easy to tell when they are starting to struggle or are showing signs of illness.  

Cats are considered elderly once they reach 11 years, with senior cats being between the ages of 11 and 14 years and geriatric cats being over 15 years.  As cats age,  they go through many behavioural and physiological changes and are more prone to developing certain illnesses in their last few years of life.  
 

What physiological and behavioural changes can you expect with your ageing cat?

As cats age, their sense of smell and taste becomes less sensitive. This means that food may need to smell a little stronger in order to appear more palatable to the cat. They also have a decreased ability to digest fat and protein so food needs to provide adequate nutrition but not be too rich. As well as sight, their hearing also diminishes and so extra care is needed to ensure they are out of the way of vehicles or they may need to be brought to their food. 

When considering their behaviour, they become less adaptable to changes in their environment and can become stressed more easily. Older cats tend to spend less time outside and more time sleeping inside.  Their appetite often decreases and they can become fussier due to their diminished sense of smell and taste. Other changes related to particular diseases may be noted. They may start to drink more water with kidney failure, or show pain and aggression due to pain and arthritis.
 

Are there any changes in routine care for your older cat?

As your cat ages, you may need to start doing a few things that weren’t necessary when they were younger and more active. Cat’s are naturally very clean animals and as they get older, grooming does become more difficult. Regularly checking your cat is advisable as problems can be picked up sooner and dealt with more efficiently.  
  • Pedicures – elderly cats are less able to retract their claws and they can become stuck on furniture and bedding. The claws also thicken with age. It is important to check them weekly to ensure that the nails are not growing into the paw pads. Some cat may need regular trimming. With advice and some training from the vet, this can be done at home and may help reduce the stress of a journey to the vet or parlour.
  • Grooming – Ageing cats may struggle to groom themselves due to athritits. Long haired cats, in particular, may need to be brushed several times a week to avoid matted fur. Their eyes may need to be cleaned occasionally with moist cotton wool. It is important to check around their “bottom” (perineum – the area around the anus and rectum) to ensure that there are no faeces stuck and there isn’t matted fur. Some cats may need to be trimmed.
  • Hairballs – The digestive system in older cats can be a little sluggish and so problems like hairballs can become more common. There are several different options when it comes to hair ball control such as food or supplements. If you are unsure if your cat is vomiting or bringing up hairballs then it is important to consult the veterinarian. 
  • Toilet habits – It is advisable to provide an indoor litter box, even if your cat normally urinates and defecates outside. As older cats are more slow and sedentary, they may not want to go very far and they are also more sensitive to the cold and wet. An indoor litter box also makes monitoring the frequency of urination and consistency of stool easier. An increase in urination may be a sign of an underlying condition such as diabetes or kidney failure. Older cats may also struggle with constipation and may need supplements or a change in food. In severe cases, the veterinarian may need to perform an enema.
  • Dental disease – As cats age, dental issues such as gingivitis (inflamed gums),  plaque build-up and loose teeth may become more of a problem. This may affect their appetite, their ability to eat, and may cause them pain. Bad breath (halitosis), drooling, loss of appetite, tooth chattering and pawing at the mouth may all be an indication that there is an underlying dental issue that may need attention. If you are in any doubt then consult the veterinarian.

How often should you take your ageing cat to the vet?

The frequency of veterinary visits will depend on the general health of your cat and any particular illnesses that they may have. Older cats that have not had any issues, are eating and drinking well and do not appear to have any signs of weight loss or other health problems should be seen at least once a year. This gives your veterinarian a chance to assess them and decide whether any procedures or tests are needed. As your cat ages, blood and urine tests are an indispensable tool in detecting problems early, before the onset of clinical signs and severe disease. In the past few years, newer generation blood tests like SDMA, have become available which can pick up kidney disease months, to even years, before it is clinically visible. The levels of these biomarkers start increasing in the blood when there is 40% loss of kidney function compared to the older type of tests where 75% of the kidney function had to be destroyed before the levels of blood markers would increase in the blood tests available to vets. Even with these new and wonderful tests, it is still quite scary to think that we can only start picking up kidney disease by the time that almost half of the kidney function is irreparably damaged. 

Unlike the liver, the kidneys do not have the capacity to regenerate, and therefore once a certain percentage of the kidneys have been damaged, there is no way of repairing it. Therefore it is so critically important that these tests be done at an earlier age, or stage of kidney disease, in order to help protect the functional part of the kidneys. 

If your cat has been diagnosed with a particular condition, visits to the vet may be required more frequently to refill medication, follow up on weight checks or do blood tests.

The following sigs are an indication that your cat should be seen by the vet:

  • Any loss of or change in appetite
  • Weight loss
  • Change in water intake- usually drinking more than normal
  • Struggling to jump, lameness or stiffness
  • Any lumps or bumps
  • Decreased energy levels
  • Balance problems
  • Difficulty in passing urine or faeces or messing in abnormal areas
  • Disorientation or distress or any change in normal behaviour
  • A coat which becomes dull
  • Any other signs of disease like vomiting or diarrhoea, change in vision, bad breath, weakness or anything else which is out of the ordinary

Detecting certain diseases early often helps improve the success of treatment so it is important to be on the lookout for any changes in your cat. Older cats will need more time and attention but with advances in veterinary medicine and care, they should be able to live their last few years in comfort and relatively free from stress.

Just like in humans, the life expectancy of animals are increasing and just as we care for the elderly in our human communities, we can show the same love and care for our geriatric pets and ensure a good quality life for them right up until the end. 

© 2018 Vetwebsites – The Code Company Trading (Pty) Ltd

My pet is vomiting

Vomiting is one of the most common symptoms of disease seen in pets. It can be quite alarming to see your pet vomit up all his or her food or alternatively continuously wretch and only bring slime or bile. So should you rush your dog or cat to the vet immediately when you see them vomit, or is it safe to wait and see? Because there are so many causes of vomiting, we recommend that if you are ever in doubt, it is always better to visit the vet and have it seen to, even if it is just to put your mind at ease and prevent it from progressing to something more serious.

It is important to realise that vomiting is not a disease or medical condition in and of itself, but rather a symptom of many different underlying causes. Healthy animals should not vomit, so there will usually be some underlying disease process which causes your animal to vomit. This could be as diverse as a brain condition, kidney disease, liver disease, gastrointestinal tract problems or endocrine conditions. It may have an infectious origin, but the cause may not be infectious at all and may vary from a physical obstruction such as a lodged bone to something as sinister as cancer. Distinguishing between vomiting and regurgitation is important. While vomiting is an active process which involves contraction of the abdominal muscles to expel the gastric content, regurgitation is a completely passive process where food is expelled from the stomach or from the oesophagus without any abdominal muscle contractions. Regurgitation usually points to a problem in the upper gastrointestinal tract, like the oesophagus. Nauseous dogs will often lick their lips and start salivating. This “overproduction” of saliva is there to protect the oesophagus against the acidic vomit moving up from the stomach by neutralising it. 

During the clinical exam, the vet will try to establish why your pet is vomiting and will decide after the clinical exam to either carry on with further diagnostic tests if he or she finds anything out of the ordinary, or send your pet home with the appropriate treatment. A full history from a vomiting animal’s owner is often the most useful diagnostic tool, so try and answer any questions the vet may have to the best of your ability. Common questions your vet may ask are: 

  • How many times has your dog or cat vomited?
  • How long has the vomiting been going on for?
  • What did your dog or cat vomit up?
  • Has your dog or cat lost any weight?
  • Is your dog or cat still eating?
  • Has their diet changed in any way?
  • What does the vomit look like?

It is important to know if there is a runny tummy (diarrhoea) associated with the vomiting and if so, to establish your pet’s hydrations status. An animal that is not keeping any fluids down, and vomits throughout the day together with losing fluids through diarrhoea can dehydrate quickly. The vet will most likely feel (palpate) your animal’s abdomen to establish if there is any pain, or perhaps a foreign body stuck somewhere which may be palpable. Depending on the size or the location of a foreign body, it may not always be possible for the vet to feel it. Severe pain in the abdomen will alert the vet to a more serious problem like pancreatitis. Dogs and cats can swallow the strangest things which may cause a blockage in the narrower parts of the digestive tract. This can become a life-threatening condition depending on the type of blockage and the length of time the foreign body is entrapped. Some foreign bodies can perforate the gut which can cause the animal to go into septic shock.

The majority of pets presenting with vomiting is due to dietary indiscretions and will recover within 24 – 48 hours. In these cases, the animal will show minimal abdominal pain, and hydration status will be normal, and temperature will be within normal limits. They are usually not severely depressed, but stay bright and alert. If the animal is bright and alert and healthy in all other respects, the vet may recommend skipping a meal or providing a liquid critical care diet together with access to fresh water. Food can then be introduced slowly over the next 12 hours. A bland diet of chicken and rice can be fed, or a veterinary therapeutic diet that is easily digestible and which has a low-fat content. 

In some cases of animals vomiting, there will be certain things that indicate to the vet that there is a more severe problem than a simple dietary indiscretion. If the vomiting has been carrying on for more than a couple of days, continuous or intermittent, further investigation is always required. Severe weight loss, dry coat and general weakness are some of the danger signs. Raised or decreased body temperature, severe abdominal pain, and accompanying bloody diarrhoea should also raise concern. These animals should ideally be admitted at the veterinary practice and rehydrated with a drip. Animals that are losing fluids by vomiting and diarrhoea often also develop electrolyte imbalances. Glucose may be low due to anorexia lasting a couple of days, and the vet will need to assess what kind of electrolyte supplementation is required with the fluid therapy. While the animal is being treated symptomatically, the vet will start with further diagnostic tests. After a basic blood smear and microscopic examination, the vet may recommend a urinalysis and faecal analysis as part of a minimum database. If the diagnosis cannot be made with these basics diagnostic tests, more comprehensive blood tests may be required which will include a full blood count, biochemistry and electrolytes. If a definitive diagnosis cannot be made with these tests, further investigation with the help of diagnostic imaging which may include X-rays and or ultrasound may be recommended. Even with extensive testing and diagnostic aids, it may not be possible to make a definitive diagnosis immediately, and in these cases, the vet will discuss the merits of further diagnostic tests or procedures, or referral to a specialist vet, with you. 

Some of the more common conditions that can present with vomiting are:

  • “Garbage disease” – where the animal eats leftover food or other items from a knocked over garbage bin 
  • Foreign bodies varying from stones to clothing garments, to anything other than pet food which the animal may have chewed and accidentally swallowed part or all of. Depending on the size and the type of foreign body it may either cause a partial obstruction or alternatively could cause a complete obstruction of the intestinal tract, which may only be rectified with surgery. 
  • Hairballs in cats
  • Pancreatitis or pancreatic tumours
  • Chronic or acute kidney disease
  • Chronic or acute liver disease including liver tumours
  • Inflammation of any part of the intestine including the mouth, oesophagus, stomach, small intestine or large intestine 
  • Megaoesophagus which may be due to auto-immune disease or other causes
  • Any tumours pressing on to, or causing an obstruction in the digestive tract
  • Gastric ulcers

The most important thing to remember is that vomiting is merely a symptom of an underlying problem which may or may not have anything to do with the intestinal tract. If your animal is vomiting and does not stop after a single episode, it is worth a visit to the vet to have it checked out.  

©2018 Vetwebsites The Code Company (Pty) Ltd

 

My older German Shepherd Dog seems to be getting weak in its hindquarters

This article outlines a genetic disorder that mainly German Shepherd dogs are prone to. There are other breeds affected by this condition too like Chesapeake Bay Retrievers, Corgis, Boxers, Wirehaired Fox Terriers and Rhodesian Ridgebacks, however, the disease is mostly seen in German Shepherds.

If one breaks down the name of the disease it describes what happens with the disease. Degeneration refers to a breaking down or deterioration of something. That “something” in this case is myelin which is the insulating sheath around neurons in the spinal cord. Neurons are the “electrical wires” of the nervous system and one can compare myelin to the insulating plastic around the wires, almost like one would find with an electrical cord. Whenever a term is followed by “pathy” it refers to a disease or disorder in a certain part of the body. In this case the spinal cord.

Degenerative Myelopathy is a debilitating condition for which there is no cure but only the potential to slow down the progress.

The occurs typically in older German Shepherd Dogs. The average age at which clinical signs start and progress is from 8 to 12 years of age. This is not a condition with rapid onset but instead is slowly progressive with clinical signs worsening with time. Degenerative myelopathy starts out as a very slowly progressive hind limb weakness and loss of function of the back legs called paresis. It is commonly confused with hip pain because the symptoms can mimic hip dysplasia, another debilitating condition with a high incidence in German Shepherds.

The condition is the result of a demyelination (loss of protective cover) and nerve degeneration of the spinal cord in the region of the mid to hind back. This degeneration is something referred to as an ascending lesion meaning that it starts at the tail end of the spinal cord and works its way towards the head. The underlying cause of the disease is thought to be a genetic mutation (change) of the SOD1 gene. This gene is responsible for the protection of cells against certain particles that damage the DNA of cells. The name given to the damaging particles are free radicles. Under normal circumstances the SOD1 gene produces a free radicle scavenger i.e. it helps to clean up the system and prevents damage to the sheath surrounding the nerves.

The way in which the defect is inherited determines whether a particular dog is at a high risk of getting the disease or if they are a carrier of the genetic mutation without showing clinical signs. An individual dog has to carry 2 copies of the mutation in the genes of the cells of their bodies for it to cause the disease. There is no sex predilection, so male or female dogs may be affected equally. What is interesting about the disease is that even if an individual dog has both copies of the mutated gene and they are at very high risk of developing the disease, there are still other factors that influence whether or not they do contract the disease and to what extent they do.  

As mentioned previously this a slowly progressive condition that has a time frame of about 3 years before severe debilitating disease sets in. The clinical signs noticed in dogs include the following:

After 6 to 12 months of contracting the disease, you will notice weakness and partial loss of function of the back legs. Your dog may seem weak and wobbly on the back legs and they may struggle to get up or be slower to get up that what they used to be. When they run, their back legs may sway abnormally.

After 9 to 18 months on contracting the disease, the back legs start to get even weaker and collapse under the dog from time to time. If one assesses the reflexes in the back legs like the patella reflex, you will find that they are abnormal and weakened.

After 12 to 24 months of contracting the disease, the front legs start to become affected and you may notice that your dog starts losing their normal co-ordination and function. By this point, the hind legs are very weak and your dog may struggle to stand and use their legs correctly. Unfortunately, the nerve degeneration also influences bladder and bowel control and they will start to urinate and defecate involuntarily. This is known as urine and faecal incontinence.

After 24 to 36 month of contracting the disease, and if the dog was able to come this far and still cope with the disease, they develop tetraplegia or quadriplegia which is a paralysis that causes partial or total loss of use of all their limbs and body. The loss is usually sensory and motor, which means that both sensation and control are lost, or put a different way, the dog does not know where its legs are and even if they did, they do not have the ability to correct it. Clearly a very unhappy situation.

The way in which this condition is diagnosed by the vet is through a number of tests as well as the typical clinical signs and also the breed of your dog. These, together with the thorough history of the condition, should provide the veterinarian with some very important clues to what is going on with your dog. The important diseases or differential diagnoses to rule out are spinal disc disease (like a slipped disc) and conditions affecting the lower part of the spine where the hips meet the spine, like hip dysplasia or joint disease. The biggest difference with degenerative myelopathy and the other conditions is that degenerative myelopathy is painless because it is the loss of sensation and function which underlies this disease. Special tests such as MRI’s may be done to visualise the damage within the spinal cord and there is also a DNA test available to check if your dog has the genetic mutation discussed earlier.

Unfortunately, there is no specific treatment available. Certain supplements can be used in an attempt to slow down the condition, such as vitamin E and aminocaproic acid. The vitamin E is an essential vitamin which helps various systems in the body to protect it from these damaging free radicles. The aminocaproic acid is an agent used to prevent the breakdown of clots in the bloodstream. The reasoning behind using this is that it is believed that the spinal cord may be indirectly attacked by the body’s own immune system. Antibodies in the bloodstream attach to the foreign material within the bloodstream forming complexes and these stimulate a response from the immune system. These complexes are usually removed by the liver and spleen. Sometimes they can stick to the walls of blood vessels, damage the walls and stimulate the formation of blood clots. The breakdown of these clots are associated with inflammation and this may result in damage to the surrounding tissues, so-called collateral damage. If this happens in the sensitive tissues of the spinal cord, the damage is devastating because the nervous tissue is not able to regenerate and repair itself. The thinking behind using aminocaproic acid is to inhibit clot breakdown in these delicate tissues.

Lastly and most importantly, the most effective treatment for this condition and the only one proven to actually slow down the progress is the use of physiotherapy and hydrotherapy. Another key factor is, the sooner the dog is diagnosed and treatment started, the better the progress of the disease can be slowed, and the more time the vet can give you with your dog. Unfortunately, the sad truth is that eventually, the disease will lead to complete paralysis and eventually, in most cases, euthanasia.

Genetic disorders like degenerative myelopathy can only be prevented by not breeding with animals where there is a family history of the disease. Make sure if you buy a puppy, that you get references on a breeder before you buy.

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